Forum for Nordic Dermato-Venereology No 3, 2019 Telemedicine | Page 7

Carsten Sauer Mikkelsen, Kristian Bakke Arvesen, Luit Penninga, Peter Bjerring – Teledermatology in the Nordic countries
with a teledermatological program and we can ensure proper
follow-up and better empowerment.
Health care expenses are under constant economical sur-
veillance and control. Special attention should be paid that
teledermatological applications are time- and cost-effective.
Teledermatology can be a cheaper and quicker access to health
care, but this requires high-quality IT-systems to allow for
very high-quality images and transmissions, proper technical
support, and effective systems. Following the fast development
within IT this need ought to be solved successfully.
Time- and cost-effective solutions are a necessity as we expect
a significant increase in the number of patients with chronic
inflammatory diseases and a higher number of older patients.
At the same time – dermatologists are expected to meet stricter
requirements for quality, service and improvement with wider
selection of new treatment options.
The potential for teledermatological consultations in the Nor-
dic countries, as well as worldwide is enormous. The global
market for teledermatology is growing rapidly. The income in
the US was 2,3 billion US$ in 2015 expecting to rise in 2021 by
over 6 billion US$ (3). In the United States, teledermatology is
already an accepted and recommended form for consultation
by the American Academy of Dermatology.
S afety
The electronic platforms used for teledermatology need to
be 100% safe. All types of correspondence between the der-
matologist and the patient has to be in a closed and secure
environment and encrypted with minimal risk for hacking
and other electronic criminality.
Legal issues regarding the use of teledermatology need to be
resolved. Specifically, the legal aspects of using digital commu-
nication need to be clarified, both concerning the exchange
of personal sensitive data between the dermatologist and the
patient, as well as regarding diagnosis and treatment without
face-to-face personal contact.
Telediagnosis in the absence of personal contact with health
care workers to the individual patient is complex. It requires
active participation of the individual patient and without
appropriate guidance this may lead to improper management
of the condition. It is important to avoid potential fatal
diagnostic teledermatological decisions. Experienced derma-
tologists express that some dermatological diseases currently
cannot be evaluated properly via a teledermatological platform
alone. More research is needed to properly assess for which
patients teledermatology can be used. It should always be
remembered that the teledermatological consultation is used
Forum for Nord Derm Ven 2019, Vol. 24, No. 3
as a supplement and not necessarily as a replacement for the
normal consultation.
F uture
applications
Already in the near future, teledermatology may be imple-
mented at hospitals and private practices to a much higher
extent than expected. For example, in Denmark at least 5–8%
of the consultations in General Practice have dermatological
relevance. Teledermatology can be used to interact with gen-
eral practitioners and dermatologists.
According to the Danish national strategy for digitalisation
the primary endpoint for teledermatology is to ensure that the
general practitioner receive proper and fast diagnostic guidance
and correct visitation for further dermatological consultation
at private practices and hospitals. The university hospitals are
expected to provide this service for both general practitioners
and dermatologists in private practices. The Danish healthcare
sector is expected to be among the best in the world to use
digital technology and ensure easy access, user-friendly solu-
tion with the highest possible quality and productivity (5).
C onclusion
Teledermatology may become of great importance for dermato-
logical care within our healthcare system. Teledermatology can
change the current paradigm of dermatological specialist care
and allow for improved health care access and improved health
outcomes. It is of utmost importance that teledermatological
solutions ensure patient safety, quality of care, and privacy
of patient data information, and it is necessary with a set of
safeguards and standards to support the use of this technology.
Special attention should be paid that teledermatological
applications are time- and cost-effective. Also, it should be
properly assessed for which patients teledermatology can be
used and it is important to realize that teledermatology not
just can replace traditional face-to-face consultations, but can
be a valuable supplement to them.
R eferences
1. Burg G, Soyer HP, Chimenti S. Teledermatology. In: EDF White
Book, Skin Diseases in Europe. Frisch P, Burgdorf W, editors. Berlin,
2005: p. 130–133.
2. Perednia DA, Brown NA. “Teledermatology: one application of
telemedicine”. Bull Med Libr Assoc 1995; 83: 42–47.
3. Global Telemedicine Market–Growth, Trends and Forecasts
(2016–2021) – Mordor Intelligence. Available at: https://www.
mordorintelligence.com.
4. Yderregisteret, Sundhedsstyrelsen – uden data fra regionsklinikker.
available at: https://sundhedsdatastyrelsen.dk.
5. National Strategy for Digitalisation of the Danish Healthcare
Service available at:https://www.medcom.dk/media/1148/digital-
isation-of-the-danish-healthcare-service.pdf.
T heme I ssue : T eledermatology
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